DR. HOOK- Hairy, barren, fat: PCOS makes life miserable

I recently received a heart-breaking letter from a woman with Polycystic Ovarian Syndrome (POCS). The classic signs are hirsuitism (hairy face and body), but male pattern baldness, acne, irregular menstrual cycles, and sometimes infertility can also present.

"Before I found out I had PCOS I felt so alone and depressed," says the Waynesboro correspondent. "I didn't know anyone else who had these problems, and being a 'fat circus freak' was scary and frightening for a young woman in a society so obsessed with physical appearances."

She says that a doctor took one look at her and blurted, "What's wrong with you?" Understandably, just leaving the house was an emotional event.

We still arent sure exactly what causes PCOS. It appears genetics are involved, and even some medicines like anti-epileptic drugs are associated. Women with PCOS have too much androgen (male sex hormone). Besides leading to some male traits that would make the beautiful Demi Moore look like her ex, Bruce Willis, PCOS can also cause some more serious effects: Type II diabetes, obesity, and polycystic ovaries

Because the ovaries dont always release an egg each month, menstrual periods dont necessarily come every month. Therefore, having a baby can be difficult and sometimes impossible. Also because the endometrial lining of the uterus becomes too thick, heavy breakthrough bleeding can occur, and there is a slight increased risk of endometrial cancer.

About five percent of women in the southeastern USA have the problem. Fifty percent of women with PCOS are obese, and most have glucose intolerance or Type II diabetes due to insulin resistance. That means the body doesnt respond well to insulin, and so the blood sugars go up like John Grishams royalties. Because of the bodys increased demand for insulin, the pancreas cranks out a lot of insulin which can cause a fatty liver, and that in time can progress to cirrhosis.

Obstructive sleep apnea is also associated with PCOS, probably because of the obesity issue, which also is associated with heart disease, as well as pulmonary hypertension, fatigue, and headaches. High cholesterol and heart disease are more prevalent with PCOS. Considering the number-one killer of women is heart disease, this should perk up everyones ears.

The Waynesboro woman says she didn't find out she had PCOS until she volunteered for a clinical study at UVA.

One reason diagnosis is so difficult is that PCOS is not a disease. It's a syndrome. A pelvic ultrasound of the ovaries usually shows numerous ovarian cysts, but this is not needed for diagnosis. A blood test (LH/FSH) on day 10 of the menstrual cycle can help confirm PCOS.

As for treatment, wanna guess what's important? Diet and exercise. Yes, I've said it a hundred times, and like a bad infomercial, Ill continue to say it.

Even just a little weight loss can restore normal menstrual periods and help fertility. Weight loss can also reduce the risk of Type II diabetes and possibly reverse the glucose intolerance. Oral contraceptives are used to help restore female traits and regulate periods. Spironolactone also combats hirsuitism, acne, and balding. But Metformin is probably the best medicine.

This diabetes medication not only treats glucose intolerance and diabetes, but with exercise, it can help the person lose weight. Stop the presses– help lose weight? Yes, it can, but the person has to exercise– which seems to be like Latin– dead.

Living a healthy lifestyle and taking the appropriate medications can help those ovaries function a little bit better.
"I remember being subjected to the stares of others," says the Waynesboro woman. "I don't want anyone else to feel this way."
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